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ASH 2025 | The impact of prophylactic immunoglobulin on infection burden with bispecific antibodies in myeloma
Efstathios Kastritis, MD, University of Athens School of Medicine, Athens, Greece, shares real-world insights on infection risk in patients with multiple myeloma treated with bispecific antibodies, particularly BCMA-targeting agents. He highlights the role of immunoglobulin replacement in reducing infections. This interview took place at the 67th ASH Annual Meeting and Exposition, held in Orlando, FL.
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Transcript
One of the major complications of treatment with bispecific antibodies and especially for antibodies that are targeting BCMA is the risk of infections that seems to be associated also with a significant risk of major complications from these infections and treatment discontinuation. So in this retrospective analysis, we analyzed all our patients who were treated with bispecific antibodies over the past three to four years...
One of the major complications of treatment with bispecific antibodies and especially for antibodies that are targeting BCMA is the risk of infections that seems to be associated also with a significant risk of major complications from these infections and treatment discontinuation. So in this retrospective analysis, we analyzed all our patients who were treated with bispecific antibodies over the past three to four years. Indeed, we identified that the risk of severe infections was high and this was higher for patients treated with BCMA-targeting bispecific antibodies versus GPRC5D-targeting bispecific antibodies. What is also important is not only the prevalence of the first grade three or four infection, but the burden of infection. So, the median number of infections was about two in patients. So, many patients did not have just a single infection, but more than one severe infection. What is also very important is that since the implementation of prophylactic use of immunoglobulins, we did see a substantial reduction in the risk of infections of any degree, but mostly respiratory grade 2 infections. The rate of reduction of grade 3 infections was not so great, but still, we will collect more data to see how the use of immunoglobulins can further decrease if there is room for further improvement in the rate of infection.
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